ABSTRACT
Chronic obstructive pulmonary disease (COPD) represents an important and
increasing burden throughout the world. Classically, COPD has been considered a
respiratory condition only, mainly caused by tobacco smoking. Indeed COPD affects
various domains within the lungs. However, COPD is a syndrome with important
manifestations beyond the lungs. The so-called systemic effects of COPD are
significant extrapulmonary effects that can be considered not organ specific, including
weight loss, nutritional abnormalities, and skeletal muscle dysfunction. All are
comprehensively reviewed elsewhere in this book. The focus of this chapter is on
organ-specific comorbidities. Comorbidities are defined here as diseases that occur
apart from COPD in a given patient, including an increased risk of cardiovascular
disease, cancers, neurologic and skeletal defects, and others. Because some
comorbidities can be either common and/or severe enough, they should be screened
and managed accordingly, to give a holistic medical care to our patients, some in
primary care and some at the specialized level. Further, not only comorbidities are
important during the life of COPD individuals. COPD-related mortality is probably
underestimated because of the difficulties associated with identifying the precise
cause of death and little is known about the underlying mechanisms of COPD
mortality. The effects of comorbidities at the time of death and on specific causes of
death in COPD are also explored. Mechanistically, the links between COPD and
comorbid conditions are not fully understood. Independent from tobacco, chronic
systemic and pulmonary inflammations are present in all stages of COPD, suggesting
a potential link through this pathway. Comorbidities are common in COPD and
should be actively identified. Comorbidities often complicate the management of
COPD, and vice versa.
